Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women: A cohort study

Kane E. Deering, Anna C. Callan, Richard L. Prince, Wai H. Lim, Peter L. Thompson, Joshua R. Lewis, Andrea L. Hinwood, Amanda Devine

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6 Citations (Scopus)

Abstract

Background: Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women. Objectives: This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women. Methods: UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2.7 years and 14.5 years of atherosclerotic vascular disease (ASVD) hospitalisations and deaths, including both the principle cause of death and all associated causes of death. Health outcome data were retrieved from the Western Australian Data Linkage System. Cox regression analysis was used to estimate hazard ratios of ASVD and all-cause mortality. UCd was ln-transformed and models were adjusted for demographic and CVD risk factors. Results: Median (IQR) concentration of UCd was 0.18 (0.09-0.32) μg/L. In multivariable-adjusted analyses per ln unit (equivalent to ~2.7 fold) increase in UCd, there was a 36% increase in the risk of death from heart failure and 17% increase in the risk of a heart failure event, respectively (HR = 1.36, 95% CI 1.11-1.67; HR = 1.17, 95% CI 1.01-1.35). When analyses were restricted to never smokers the relationship between UCd and death from heart failure remained (HR 1.29, 95% CI 1.01-1.63). Conclusions: This study suggests that even at low levels of exposure cadmium may be associated with heart failure hospitalisations and deaths in older women, however given the dilute nature of these urine samples, the results must be interpreted with caution.

Original languageEnglish
Pages (from-to)347-354
JournalInternational Journal of Hygiene and Environmental Health
Volume221
Issue number2
DOIs
Publication statusPublished - Mar 2018

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Cadmium
Cohort Studies
Heart Failure
Cardiovascular Diseases
Vascular Diseases
Cause of Death
Hospitalization
Mortality
Information Storage and Retrieval
Information Systems
Observational Studies
Regression Analysis
Demography
Urine
Health

Cite this

@article{a1fdce6e13744d45aebd296491c0a6f6,
title = "Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women: A cohort study",
abstract = "Background: Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women. Objectives: This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women. Methods: UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2.7 years and 14.5 years of atherosclerotic vascular disease (ASVD) hospitalisations and deaths, including both the principle cause of death and all associated causes of death. Health outcome data were retrieved from the Western Australian Data Linkage System. Cox regression analysis was used to estimate hazard ratios of ASVD and all-cause mortality. UCd was ln-transformed and models were adjusted for demographic and CVD risk factors. Results: Median (IQR) concentration of UCd was 0.18 (0.09-0.32) μg/L. In multivariable-adjusted analyses per ln unit (equivalent to ~2.7 fold) increase in UCd, there was a 36{\%} increase in the risk of death from heart failure and 17{\%} increase in the risk of a heart failure event, respectively (HR = 1.36, 95{\%} CI 1.11-1.67; HR = 1.17, 95{\%} CI 1.01-1.35). When analyses were restricted to never smokers the relationship between UCd and death from heart failure remained (HR 1.29, 95{\%} CI 1.01-1.63). Conclusions: This study suggests that even at low levels of exposure cadmium may be associated with heart failure hospitalisations and deaths in older women, however given the dilute nature of these urine samples, the results must be interpreted with caution.",
keywords = "Cadmium, Cardiovascular, Elderly women, Heart failure",
author = "Deering, {Kane E.} and Callan, {Anna C.} and Prince, {Richard L.} and Lim, {Wai H.} and Thompson, {Peter L.} and Lewis, {Joshua R.} and Hinwood, {Andrea L.} and Amanda Devine",
year = "2018",
month = "3",
doi = "10.1016/j.ijheh.2017.12.007",
language = "English",
volume = "221",
pages = "347--354",
journal = "International Journal of Hygiene and Environmental Health",
issn = "1092-5732",
publisher = "Urban und Fischer Verlag Jena",
number = "2",

}

TY - JOUR

T1 - Low-level cadmium exposure and cardiovascular outcomes in elderly Australian women

T2 - A cohort study

AU - Deering, Kane E.

AU - Callan, Anna C.

AU - Prince, Richard L.

AU - Lim, Wai H.

AU - Thompson, Peter L.

AU - Lewis, Joshua R.

AU - Hinwood, Andrea L.

AU - Devine, Amanda

PY - 2018/3

Y1 - 2018/3

N2 - Background: Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women. Objectives: This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women. Methods: UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2.7 years and 14.5 years of atherosclerotic vascular disease (ASVD) hospitalisations and deaths, including both the principle cause of death and all associated causes of death. Health outcome data were retrieved from the Western Australian Data Linkage System. Cox regression analysis was used to estimate hazard ratios of ASVD and all-cause mortality. UCd was ln-transformed and models were adjusted for demographic and CVD risk factors. Results: Median (IQR) concentration of UCd was 0.18 (0.09-0.32) μg/L. In multivariable-adjusted analyses per ln unit (equivalent to ~2.7 fold) increase in UCd, there was a 36% increase in the risk of death from heart failure and 17% increase in the risk of a heart failure event, respectively (HR = 1.36, 95% CI 1.11-1.67; HR = 1.17, 95% CI 1.01-1.35). When analyses were restricted to never smokers the relationship between UCd and death from heart failure remained (HR 1.29, 95% CI 1.01-1.63). Conclusions: This study suggests that even at low levels of exposure cadmium may be associated with heart failure hospitalisations and deaths in older women, however given the dilute nature of these urine samples, the results must be interpreted with caution.

AB - Background: Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women. Objectives: This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women. Methods: UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2.7 years and 14.5 years of atherosclerotic vascular disease (ASVD) hospitalisations and deaths, including both the principle cause of death and all associated causes of death. Health outcome data were retrieved from the Western Australian Data Linkage System. Cox regression analysis was used to estimate hazard ratios of ASVD and all-cause mortality. UCd was ln-transformed and models were adjusted for demographic and CVD risk factors. Results: Median (IQR) concentration of UCd was 0.18 (0.09-0.32) μg/L. In multivariable-adjusted analyses per ln unit (equivalent to ~2.7 fold) increase in UCd, there was a 36% increase in the risk of death from heart failure and 17% increase in the risk of a heart failure event, respectively (HR = 1.36, 95% CI 1.11-1.67; HR = 1.17, 95% CI 1.01-1.35). When analyses were restricted to never smokers the relationship between UCd and death from heart failure remained (HR 1.29, 95% CI 1.01-1.63). Conclusions: This study suggests that even at low levels of exposure cadmium may be associated with heart failure hospitalisations and deaths in older women, however given the dilute nature of these urine samples, the results must be interpreted with caution.

KW - Cadmium

KW - Cardiovascular

KW - Elderly women

KW - Heart failure

UR - http://www.scopus.com/inward/record.url?scp=85040359901&partnerID=8YFLogxK

U2 - 10.1016/j.ijheh.2017.12.007

DO - 10.1016/j.ijheh.2017.12.007

M3 - Article

VL - 221

SP - 347

EP - 354

JO - International Journal of Hygiene and Environmental Health

JF - International Journal of Hygiene and Environmental Health

SN - 1092-5732

IS - 2

ER -